Individual provider Active NPI

Parnell J Crump Jr., OD

  • Optometrist
  • Bradenton, FL
National Provider Identifier
1275732836
Registry record updated Oct 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC2343 Issued in FL
Practice address
5306 Cortez Rd W
Suite 3
Bradenton, FL 34210-2821
Phone
(941) 794-1333
Fax
(941) 794-5640
NPI assigned
Jul 13, 2007
Last updated
Oct 22, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC2343 FL Primary

Addresses

Primary practice location

5306 Cortez Rd W
Suite 3
Bradenton, FL 34210-2821

Mailing address

5306 Cortez Rd W
Suite 3
Bradenton, FL 34210-2821
Phone (941) 794-1333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060110000214 FL Practitioner - Optometry 6709809478 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gulf Coast Optometry PAGroup PAC ID 0941359533, 22 clinicians

Practice addresses (Care Compare)

4001 1St St
Bradenton, FL 34208-4431
Phone (941) 745-9800

5306 Cortez Rd W
Suite 3
Bradenton, FL 34210-2821
Phone (941) 794-1333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2343FLMDPastoral Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf Coast Optometry, PA CurrentSince Jan 14, 2015 Accepting new patients
Jay Crump OD PA Optometrist CurrentSince Dec 6, 2005 Accepting new patients
National Vision, Inc. Past Accepting new patients
National Vision, Inc. Past Accepting new patients

Locations

706 W State Road 436
Altamonte Springs, FL 32714
Phone (407) 774-1318

4001 1st St E
Bradenton, FL 34208
Phone (941) 745-9800

5306 Cortez Rd W
Ste 3
Bradenton, FL 34210
Phone (941) 794-1333

1411 S 14th St
Ste G
Fernandina Beach, FL 32034
Phone (904) 321-1333

4957 S Cleveland Ave
Fort Myers, FL 33907
Phone (239) 278-1217

2411 SW College Rd
Ocala, FL 34471
Phone (352) 873-3937

2241 Tamiami Trl
Port Charlotte, FL 33948
Phone (941) 629-9309

77 N Cattlemen Rd
Sarasota, FL 34243
Phone (941) 893-6109

2109 66th St N
St Petersburg, FL 33710
Phone (727) 342-5226

3520 4th St N
St Petersburg, FL 33704
Phone (727) 369-0043

Networks

  • Freedom Health HMO Network

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445472000000",
    "number": "1275732836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5306 CORTEZ RD W",
            "address_2": "SUITE 3",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342102821",
            "telephone_number": "941-794-1333",
            "fax_number": "941-794-5640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5306 CORTEZ RD W",
            "address_2": "SUITE 3",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342102821",
            "telephone_number": "941-794-1333",
            "fax_number": "941-794-5640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUMP",
        "first_name": "PARNELL",
        "middle_name": "J",
        "name_suffix": "Jr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-13",
        "last_updated": "2015-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC2343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.